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c19early.org COVID-19 treatment researchInhaled HeparinInhaled Heparin (more..)
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ DeNucci (DB RCT) 42% 0.58 [0.24-1.44] death 6/38 10/37 Improvement, RR [CI] Treatment Control Smith (RCT) -70% 1.70 [0.16-17.6] death 2/27 1/23 Intubated patients INHALE-HEP van Haren (RCT) 58% 0.42 [0.21-0.80] death 12/182 29/186 Tau​2 = 0.00, I​2 = 0.0%, p = 0.0077 Late treatment 50% 0.50 [0.30-0.83] 20/247 40/246 50% lower risk All studies 50% 0.50 [0.30-0.83] 20/247 40/246 50% lower risk 3 inhaled heparin COVID-19 studies c19early.org November 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.0077 Effect extraction pre-specified(most serious outcome, see appendix) Favors inhaled heparin Favors control
Inhaled nebulized unfractionated heparin shows antiviral, anti-inflammatory, and anti-coagulant effects which may minimize viral entry, progression of lung injury, and pulmonary thrombosis. Recent:
DeNucci
Smith
van Haren.
Nov 6
Covid Analysis Inhaled Heparin reduces COVID-19 risk: real-time meta analysis of 3 studies
Significantly lower risk is seen for mortality, ventilation, and hospitalization. One study shows significant benefit. Meta analysis using the most serious outcome reported shows 50% [17‑70%] lower risk. Currently all studies a..
Oct 31
van Haren et al., eClinicalMedicine, doi:10.1016/j.eclinm.2025.103339 Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19: an investigator-initiated international meta-trial of randomised clinical studies
58% lower mortality (p=0.01), 47% lower ventilation (p=0.01), and 23% lower hospitalization (p=0.02). Meta-trial of 6 RCTs with 478 hospitalized COVID-19 patients showing significant benefit with inhaled nebulized unfractionated heparin (UFH). Patients receiving nebulized UFH had lower rates of intubation or death at longest follow-up (11..
Mar 27
Smith et al., Anaesthesia and Intensive Care, doi:10.1177/0310057X251322783 A randomised, open-label trial of nebulised unfractionated heparin in patients mechanically ventilated for COVID-19
70% higher mortality (p=1). RCT 50 intubated COVID-19 patients showing no improvement with inhaled nebulized unfractionated heparin. Time to separation from invasive ventilation among survivors to day 28 was significantly slower in the heparin group.
Jun 30
2023
DeNucci et al., Pulmonary Pharmacology & Therapeutics, doi:10.1016/j.pupt.2023.102212 Inhaled nebulised unfractionated heparin (UFH) for the treatment of hospitalised patients with COVID-19: A randomised controlled pilot study
42% lower mortality (p=0.27), 42% lower ventilation (p=0.27), and 5% shorter hospitalization (p=0.8). RCT 75 hospitalized patients with COVID-19 showing reduced mortality with inhaled nebulized unfractionated heparin (UFH).
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